The difference between integrative medicine and a primary care office
Since opening my integrative medicine practice almost two years ago, I’ve been grateful to work with many patients who have found the conventional medical system lacking. One question that comes up pretty frequently is about how much what I’m doing overlaps with what a traditional primary care physician would be doing.
People who are seeking to address chronic disease and take more control over their health and wellness are often not sure what to look for. Should they visit a primary care physician who understands the importance of nutrition, mindfulness, and sleep? Should they be looking for an integrative primary care doctor? Or some combination of conventional and integrative medicine?
To answer the question: my practice is not intended to replace a patient’s primary care physician. My strong recommendation is that my patients maintain their relationship with their primary care physician (PCP), if they have one—those visits are often covered by most health insurance. More importantly, the long-term relationship and regular check-ins with a good PCP are invaluable. If the primary care office is connected to a larger health system, your patient record can also be maintained over years, even if the PCP retires or moves away.
My integrative medicine practice is intended to fill the gaps and supplement what the conventional model of primary care is often lacking. This is not to diminish the many excellent primary care doctors near me and throughout the country. Nevertheless, the financial model they operate under simply doesn’t make the time or provide the incentive for what an integrative medicine office like mine can.
I’ve already written about the 11 differences between integrative and conventional medicine. But here are two of the core differences between what I do and a primary care physician specifically:
Symptom approach vs. holistic approach
While the best PCPs will make suggestions on appropriate nutrition and exercise routines the reality is many are too time-pressed to provide this level of detailed lifestyle changes. A conventional primary care physician generally will take a symptom approach to your care. Aside from your annual visit, you are only likely to show up to a primary care physician when you are experiencing an acute episode of a particular symptom. So, for example, you go to see your PCP about abdominal pain, or perhaps a particularly acute and persistent series of headaches. Then, depending on the examination, they may either prescribe or treat you or refer you to a specialist.
Unfortunately, most PCPs only have in the range of 15-20 minutes to make these determinations, due to financial constraints and the need to see a lot of patients every day. Then, you are unlikely to see the PCP again until another episode arises.
Meanwhile, at Dignity Integrative, my initial intake is usually 90 minutes, during which we discuss not just any chronic issues, but also your entire history, prior labs, and your health and wellness goals (see my approach here). After the initial intake, a health coach meets with you once a month to check in on progress and revise goals and treatments if necessary.
The additional time allows integrative medicine practices to take a more holistic approach to your care, incorporating conventional medicine with alternative therapies and a focus on treating the whole person. Which brings me to the next difference.
Pharmacological approach vs. treating the whole person
The fact is, much of traditional medicine remains stuck in the mindset of offering a pharmacological solution for every problem. Depression? Here we have SSRIs. High cholesterol? Here we have statins. For much too long, traditional healthcare has taken the position that if you have a problem, we have a pill.
As I wrote over the Summer, this is beginning to change: integrative medicine is fast becoming the conventional wisdom within medicine. Yet I continue to be surprised at the number of primary care doctors who don’t know that much about nutrition. This is because, aside from the relatively basic advice to eat less processed foods and more greens, nutrition still is not a part of our medical training, even for cardiologists!
Furthermore, as noted above, the payment models for conventional medicine just have not caught up to the fact that many of the most common chronic diseases can be treated and even reversed by changes to lifestyle and diet, and by devoting more focus to things like mental wellbeing and sleep.
Are there integrative primary care physicians?
Ideally, we would redo our healthcare system to align the incentives of healthcare providers with promoting actual health and wellness. In this imagined future, we might have integrative primary care physicians who have the time and incentives to take a holistic approach to improving the healthspans of their patients.
Unfortunately, right now an integrative primary care physician is a rarity. We still have conventional primary care doctors, and also integrative medicine practitioners like me.
The advantage of traditional primary care is that your visits are usually covered by insurance. In theory, they are also intended to follow you over the course of your entire life (although changing health insurance, moving states or staffing changes mean this rarely happens in practice).
Yet, for the reasons I’ve written about before, traditional primary care is falling short, especially in its ability to help patients address chronic health issues. The advantage of an integrative medicine (or functional medicine) office is the time afforded to take a holistic approach that considers the physical, emotional, mental, and spiritual aspects of a person's health.
If you are ready to start a journey toward better healthspan or need help addressing a chronic condition, feel free to book a free, 15-minute consultation with Dignity Integrative.